Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | A112527 | CA |
N | 207SG0201X | Clinical Genetics (M.D.) | MD169269 | OR |
N | 208000000X | Pediatrician | A112527 | CA |
NPI | 1497045298 |
---|---|
Provider Name | Dr. Chung Un Lee |
First Address | Palo Alto, CA 94303-3341 |
Second Address | Palo Alto, CA 94304-1601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2011 |
Last Update Date | 02/02/2016 |